MEDICARE: DR. ROSE MARIA CUNNINGHAM-AHUMADA D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	20A8199	CA
2	207W00000X	Ophthalmology Physician	5101015522	MI

General Provider Information

NPI Number	:	1811996523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSE MARIA CUNNINGHAM-AHUMADA D.O.

Provider Business Mailing Address
First Line	:	2621 S BRISTOL ST
Second Line	:	SUITE 205
City	:	SANTA ANA
State	:	CA
Zip	:	92704-5766
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2621 S BRISTOL ST
Second Line	:	SUITE 205
City	:	SANTA ANA
State	:	CA
Zip	:	92704-5766
Country	:	US
Telephone Number	:	714-557-5777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	03/22/2010

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